Question

what is diabetic ketoacidosis?

Answer 1

DIABETIC KETOACIDOSIS

Diabetic ketoacidosis is a complication of diabetes which is usually seen in mostly patients who have type 1 diabetes ( means where the insulin deficiency is present from childhood) but in type 2 diabetes patients can also be seen. Insulin have an important role in glucose metabolism and this glucose is transferred to cells to provide energy . But in absence of glucose the body breakdown the fat into ketone bodies for providing energy. The fact is that all cells can utilize the ketone bodies except brain cell for this reason diabetes ketoacidosis leads to cerebral edema means swelling of brain.

Clinical symptoms are like - excessive thrust is felt, nausea ,vomiting, dehydration , frequently urge of urination, fruity smelling breath, fatigue, abdominal pain .

MECHANISMS--

Two things occurred 1) dehydration is occured . Insulin deficiency and along with epinephrine release leads to excessive glucagon secretion which leads to peripheral glucose utilisation which ultimately causes severe form of hyperglycemia ( when blood glucose level is more than 500 mg/dL. And that causes dehydration and excessive urination.

2) ketogenesis occurs. When insulin deficiency present leads to lipoprotein lipase activation which leads to fat breakdown and formation of free fatty acids. Now these free fatty acids active fatty acyl coenzyme A .now in liver cells fatty acyl coenzyme A forms ketone bodies( means acetoacetic acid, acetone, betahydroxybutyric ). Now these ketone bodies are results in ketonemia( presence of ketone bodies in blood),ketonuria( ketone bodies present in urine).

DIAGNOSIS--

1) blood glucose level examination is done . In diabetic ketoacidosis the blood glucose level reaches 500 mg/dL.

2) presence of ketonebodies in blood.

3) The pH level of blood decreases as the acidosis occurs.

4) presence of ketone bodies in urine examination.

TREATMENT--

1) Fluid therapy intravenous-- as there is presence of dehydration so, external intravenous fluid should be given.

2) Electrolytes replacement therapy-- as there is a chance of Electrolytes imbalance in this case so replacement is needed. In either oral or intravenous form.

3) Insulin therapy should be given as it occurs due to insulin deficiency.